Frailty Is Associated With Cognitive Decline Independent of Cerebral Small Vessel Disease and Brain Atrophy

Abstract

Background To examine the effect of frailty on cognitive decline independent of cerebral small vessel disease (cSVD) and brain atrophy, and whether associations between neuropathology and cognition differed depending on frailty status. Methods The Tasmanian Study of Cognition and Gait (TASCOG) was a population based longitudinal cohort study with data collected at three phases from 2005 to 2012. Participants aged 60–85, were randomly selected from the electoral roll. Various data were used to operationalize a 36-item Frailty Index (FI) at baseline. Brain MRI was undertaken to obtain baseline measures of neuropathology. A neuropsychological battery was used to assess cognition at each time point. Generalized linear mixed models were used to examine the effect of frailty and MRI measures on cognition over time. The associations between MRI measures and cognition were explored after stratifying the sample by baseline frailty status. All analyses were adjusted for age, sex and education. Results A total of 385 participants were included at baseline. The mean age was 72.5 years (SD 7.0), 44% were female (n=171). In fully adjusted linear mixed models, frailty (FI × time β -0.001, 95% CI -0.003, -0.001, p = 0.03) was associated with decline in global cognition, independent of brain atrophy and cSVD. The association between cSVD and global cognition was significant only in those with low levels of frailty (p=0.03). Conclusions These findings suggest that frailty is an important factor in early cognitive dysfunction, and measuring frailty may prove useful to help identify future risk of cognitive decline.

Higher frailty levels are associated with lower cognitive test scores in a multi-country study: evidence from the study on global ageing and adult health

“…Although the tree is recommended only as an aid in assessing an older adult, it could be useful as a screen measure in an incremental approach to assessing older adults. Other studies have shown similar results, using other tools to measure frailty and other cognitive tests, whilst results seem consistent with that previously reported ( 12 , 33–37 ). Moreover, one of the advantages that the CFS has is the ability to capture a continuum of frailty, rather than a limited ‘all or nothing’ grouping that almost all the other tools used for assessing frailty provide.…”

Understanding exogenous factors and biological mechanisms for cognitive frailty: a multidisciplinary scoping review

“…They used the number of deficits in a Fried frailty profile (1, 2 or 3+) to show that these cognitive impairments were related to severity of frailty. Other studies distinguished between executive function and/or processing speed as associated with frailty, pre-frailty, and frailty components such as hand-grip strength, gait speed or sarcopenia, versus memory or global cognition which were not (Amanzio et al, 2021; Chou et al, 2019; Chu, Xue, et al, 2021; Gross et al, 2016; Inoue et al, 2022; Kaur et al, 2019; Kim & Won, 2019; Sharifi et al, 2021; Siejka et al, 2022). Shim et al, (2020) showed the same pattern for the MCR syndrome and Wu et al, (2015) demonstrated the same for pre-frail participants, but that frailer participants also had a higher risk for memory impairments.…”

Does cognitive frailty predict delayed neurocognitive recovery after noncardiac surgery in frail elderly individuals? Probably not

“…As noted in previous work, some studies showed no significant difference in the incidence of DNR between MCI and non-MCI patients (Bekker et al, 2010 ; Trubnikova et al, 2014 ; Maleva et al, 2020 ), which indicated that MCI might not be a predictor for DNR. Although some studies have shown that frailty is an essential factor in cognitive dysfunction (Siejka et al, 2022 ), they are mostly based on community-dwelling elderly samples, and the majority of studies have mainly focused on exploring the relationship between frailty and long-term changes in cognitive function. In our study, we followed up only for a short time for the occurrence of DNR and did not find any association between cognitive frailty and DNR.…”